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Related Experiment Videos

Borderline rage and the therapist's reponse

T Nadelson

    The American Journal of Psychiatry
    |July 1, 1977
    PubMed
    Summary

    Borderline patients

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    Carol C. Nadelson, M.D., one hundred fourteenth president, 1985- 1986, American Psychiatric Association.

    The American journal of psychiatry·1986

    Area of Science:

    • Psychology
    • Psychiatry
    • Psychoanalysis

    Background:

    • Borderline personality disorder (BPD) frequently evokes intense emotional responses in therapists, including apathy and rage.
    • Therapist reactions such as withdrawal or anger can mirror the patient's own projected affect.
    • Understanding the patient's internal world requires careful attention to the therapist's emotional state.

    Purpose of the Study:

    • To explore the defensive function of rage in borderline patients.
    • To examine the role of projective identification in the therapeutic relationship.
    • To understand how therapist countertransference can be utilized for therapeutic insight.

    Main Methods:

    • Psychoanalytic theoretical framework.
    • Exploration of transference and countertransference dynamics.
    • Clinical case conceptualization.

    Main Results:

    • Borderline patient rage is interpreted as a defense against profound fear of annihilation.
    • This fear stems from projective identification with hostile internal object relations.
    • Therapist countertransference, if not carefully managed, can lead to distorted understanding.

    Conclusions:

    • Therapist's affective state is a crucial diagnostic tool for understanding the borderline patient's vulnerability.
    • Overcoming defensive rage requires the therapist to tolerate and interpret the patient's underlying terror.
    • Achieving therapeutic clarity necessitates self-awareness and careful management of countertransference.

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